Paul, a computer programmer who is currently unemployed, is 38 years old and in the process of “detransitioning,” undoing steps towards the sex change he began a decade ago.

Before “transitioning” from male to female, Paul struggled with dysphoria for years. He remembers his high school days filled with shame over his “girlish” interests and peer groups and struggling with gynecomastia (swollen breast tissue in males), isolation, and confusion. When Paul first learned about transgenderism from an article in his student newspaper, he felt he had found the missing piece.

“I wasn’t deranged or simply gay, but instead I misunderstood what a ‘woman’ was, that the term was entirely social, and that my failure to be accepted as a man was because I was really a woman,” he said. Paul never viewed his transformation as a sex change, but as an escape from his gender.

After moving to San Francisco in search of community and acceptance, Paul, uninsured, stumbled across a community health clinic. Upon his first visit, he was prescribed male-to-female hormones, given very little information on the risks and potential side effects, and told “not to worry” whenever he expressed concern about drugs or long-term side effects.

From Hormones to Surgery

After five years of transitioning, Paul sought a way out. Following a poor experience on hormones and wanting to sever his dependence from medication, his doctor suggested an orchiectomy, the removal of one’s testicles, which he was told would allow the hormone intake to stop. With hopes of a life independent of medicine and dysphoria, surgery seemed a saving grace.

“On the day of surgery, I was surprised at how it was suddenly unfolding into something larger than I expected. I tried to stop them, but I was then anesthetized. After surgery, I went into shock at how thoroughly I’d been altered in both appearance and function,” Paul says. “I was a sex addict, and sex was now disrupted. I also now found myself in a constant, low level of groin pain. A year later, the bleeding began. I was told to wait it out, see a specialist, and not to get a lawyer.”

After a painful recovery, Paul was told that, despite having been told otherwise before surgery, he couldn’t actually stop hormone treatment. He confronted his doctor, whom Paul says admitted to lying, claiming “rules were broken for his benefit, to increase access to care.”

Despite Dropping the Hormones, Paul Can’t Go Back

Paul quit the hormones anyway and his detransition took place over the next three years, but not easily: “I became sick and suicidal. The groin pain increased sharply, and my mirror reflection changed. I attempted suicide, and I then began reaching out for help. I saw several therapists. I quit wearing women’s clothes, and I began changing my name and ID docs.”

When asked what Paul’s biggest worries are during his detransition, he tells me: “I feel and look awful. What pains and horrors await me in middle age? Will I live to old age?”

He also fears the future of his romantic endeavors. “I seem to be either a de-sexed monstrosity, or I’m a damaged, mutilated male. I’ve been alone a long time. I’ve been forced into celibacy. I yearn for mere conversation and cuddling.”

Paul has been officially diagnosed with gender dysphoria, and learned that he falls on the autism spectrum.

In an era where transgender rights are at the forefront of social politics, media does its part to selectively inform people about the realities of transition. Transition guides tailored to teens are made up of cartoons and glittered chest binders. Stories on detransitioners are written off as “uncommon” or “myths,” and those who dare tell the stories of those who regret their transition meet repercussions.

When a Man ‘Becomes’ a Woman

Taylor is a student who began transitioning at the age of 23. It started simply.

“All it took was self-declaration. The first thing I did was change my name,” Taylor said. “I wore makeup and committed to growing my hair out and wore more feminine clothing. All of the changes were superficial and followed pretty basic stereotypes of how women appear to the male gaze.”

After a year of living with a feminine name and pronouns, Taylor began hormone therapy. His choice to transition seemed obvious to him: “I wanted to be a woman. Badly. My mental health was very poor at the time and I was very much socially isolated. I felt I could either try living as a woman or else I wanted to kill myself.”

Not finding satisfaction in his new identity, Taylor began the detransition process after a year, quitting hormones and reverting back to a masculine expression of self. He described to me his disappointment in the system.

“I wish I had been challenged by a doctor,” he says. “I went to an endocrinologist, who gave me a prescription on the first visit, before my blood work results even came back. ‘It’ll be fine, congratulations!’ was his attitude. The doctor should’ve challenged me.”

What Former Trans People Advise Potential Trans People

Taylor’s advice to those questioning themselves is ominous: “Our physical bodies, with genitalia and chromosomes, exist in reality, and part of having a body is hating your body. You are taught to hate your body no matter who you are, male or female, and you are falling for it.”

It isn’t all rainbows and book deals. Trans teen idol Jazz Jennings speaks freely about the glamour of embracing one’s self, but little has been published on the complications regarding Jazz’s bottom surgery. His doctors said there wasn’t enough “raw material” to work with due to Jazz’s early consumption of puberty blockers, which stunted genitalia formation.

Undergoing gender reassignment is regarded as the Holy Grail for those struggling with their sex. When the potentially fatal outcomes are not adequately tracked, however, shouldn’t honesty be the priority when speaking about the lifelong effects of the transition process?

Paul’s advice to children looking to transition? “Don’t.”

Some names and identifying details have been changed to protect individuals’ privacy.

Taylor Fogarty is a Brooklyn-dwelling freelancer who writes about feminism, politics, and anything else she has an opinion on. She also tweets a lot: @theloudlesbian.